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September 1984

Parkinson's Disease: The Possible Relationship of Laterality to Dementia and Neurochemical Findings

Author Affiliations

From the Departments of Neurology (Drs Direnfeld, Albert, and Kaplan) and Pharmacology (Dr Marquis), Boston University School of Medicine; Boston Veterans Administration Medical Center (Drs Direnfeld, Albert, and Kaplan); the Departments of Pharmacology and Medicine, E. N. Rogers Memorial Veterans' Hospital, Geriatric Research and Educational Clinical Center, Bedford, Mass (Dr Volicer); and the Brain Tissue Resource Center, McLean Hospital, Belmont, Mass (Mr Langlais). Dr Direnfeld is now with the Maui Clinic, Kahului, Hawaii.

Arch Neurol. 1984;41(9):935-941. doi:10.1001/archneur.1984.04050200041016

• We examined the relationship of disease laterality to neuropsychological and neurochemical features in patients with idiopathic Parkinson's disease (PD). We tested patients with PD, patients with Alzheimer's type of senile dementia, and a control group neuropsychologically, and we determined their CSF levels of homovanillic acid, 3,4-dihydroxyphenylacetic acid, 3-methoxy-4-hydroxyphenylglycol, 5-hydroxyindolacetic acid, serotonin, and acetylcholinesterase. The patients with PD were divided into two groups depending on the side of the body with greater disease involvement. Both parkinsonian groups, those more affected on the left (group L) and those more affected on the right (group R), were otherwise similar in all other clinical and historical features. Group L patients showed greater neuropsychological impairments than group R patients. Group L also had significantly higher CSF levels of homovanillic acid and acetylcholinesterase than group R. These findings of neuropsychological and neurochemical differences between groups L and R suggest functional or anatomic asymmetries of dopaminergic systems in the CNS.

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